The main symptoms of CADASIL are stroke, cognitive impairment, migraine with aura and psychiatric disturbances. Strokes occur because blood flow to the brain is blocked or slowed. The brain ends up lacking oxygen. This can result in weakness of arms or legs, speech and communication difficulties or other problems. Mini-strokes called transient ischemic attacks or TIAs can also occur. Stroke and TIAs can occur multiple times and cause significant disability.
Cognitive impairment refers to a decline in cognitive function. Cognitive function is a person’s ability to process thoughts and reason. It involves memory, perception, thinking, and reasoning. People will begin to have difficulty with everyday tasks and their daily routines. Eventually, cognitive decline results in dementia.
Migraine with aura refers to migraine headaches that occur with "aura", which are additional symptoms such as flashes of light, blind spots or tingling of the hands or face. Migraine with aura often occurs before people have strokes or dementia. The "aura" symptoms may occur just before a migraine develops.
Psychiatric disturbances can include depression, bipolar disorder, panic disorder, apathy, delusional episodes, disturbed sleep, irritability, and changes in behavior. Seizures (epilepsy) is an infrequent finding in CADASIL, but can occur, usually following a stroke.
The course of how these symptoms develop and progress can be very different in one person when compared to another. This is true even for members of the same family. For example, some people do not develop migraines or do not develop psychiatric symptoms.
